title: Muscle ischaemia in peripheral vascular disease studied by 31P-magnetic resonance spectroscopy.
abstract: We have used 31phosphorus magnetic resonance spectroscopy (31P-MRS) to study foot muscle metabolism in patients with peripheral vascular disease. Sixteen patients with calf claudication, 32 patients with rest pain and 13 control subjects had spectra collected from the foot muscle, Extensor digitorum brevis, ankle pressures measured and, in most cases, transcutaneous O2 and CO2 recordings made over the foot. The intracellular pH and the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) obtained from the MR spectra were significantly higher (p less than 0.005 and p less than 0.02, respectively) in the muscle of patients with rest pain and were particularly high in those with gangrene or ulceration. Ankle pressures and transcutaneous O2 and CO2 measurements failed to distinguish those patients with advanced peripheral ischaemia. These results suggest that MRS measurements of metabolic changes in foot muscle are useful in the detection and quantitation of significant distal ischaemia.
authors.affiliation: Magnetic Resonance Facility, University of Oxford, John Radcliffe Hospital, U.K.
authors.forename: L J
authors.initials: LJ
authors.lastname: Hands
authors.forename: M H
authors.initials: MH
authors.lastname: Sharif
authors.forename: G S
authors.initials: GS
authors.lastname: Payne
authors.forename: P J
authors.initials: PJ
authors.lastname: Morris
authors.forename: G K
authors.initials: GK
authors.lastname: Radda
mesh_terms: D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D005260:Female; D005528:Foot; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis*; D007511:Ischemia / Q000175:diagnosis; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009132:Muscles / Q000098:blood supply* / Q000378:metabolism; D010710:Phosphates / Q000032:analysis; D010725:Phosphocreatine / Q000032:analysis
chemical_list: D010710:Phosphates; D010725:Phosphocreatine